Review Article | Published:

Seasonal variations in cardiovascular disease

Nature Reviews Cardiology volume 14, pages 654664 (2017) | Download Citation

Abstract

Cardiovascular disease (CVD) follows a seasonal pattern in many populations. Broadly defined winter peaks and clusters of all subtypes of CVD after 'cold snaps' are consistently described, with corollary peaks linked to heat waves. Individuals living in milder climates might be more vulnerable to seasonality. Although seasonal variation in CVD is largely driven by predictable changes in weather conditions, a complex interaction between ambient environmental conditions and the individual is evident. Behavioural and physiological responses to seasonal change modulate susceptibility to cardiovascular seasonality. The heterogeneity in environmental conditions and population dynamics across the globe means that a definitive study of this complex phenomenon is unlikely. However, given the size of the problem and a range of possible targets to reduce seasonal provocation of CVD in vulnerable individuals, scope exists for both greater recognition of the problem and application of multifaceted interventions to attenuate its effects. In this Review, we identify the physiological and environmental factors that contribute to seasonality in nearly all forms of CVD, highlight findings from large-scale population studies of this phenomenon across the globe, and describe the potential strategies that might attenuate peaks in cardiovascular events during cold and hot periods of the year.

Key points

  • Seasonal variations across a broad range of populations and climates (but predominantly derived from the temperate climates of Europe) have been documented in all types of cardiovascular disease (CVD)

  • Most studies report 'winter peaks' in CVD-related hospitalizations and mortality; event rates in winter are typically 10–20% greater than during 'summer troughs'

  • CVD seasonality is probably caused by a complex interaction between the susceptibility of individuals and a range of environmental factors (including ambient temperature)

  • CVD seasonality is most pronounced in individuals living in milder climates, who are least prepared for extreme weather variations

  • A lag effect, potentially modulated by air pollution levels and concurrent influenza, has been documented after 'cold snaps'

  • Potential exists to attenuate seasonality in CVD via multifaceted interventions that modulate exposure to various provocations to the cardiovascular system in high-risk individuals (those with established CVD)

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References

  1. 1.

    Hippocrates & Galen. The Writings of Hippocrates and Galen (1846).

  2. 2.

    et al. Seasonal variation of overall and cardiovascular mortality: a study in 19 countries from different geographic locations. PLoS ONE 9, e113500 (2014).

  3. 3.

    , , & Assessment and management of blood-pressure variability. Nat. Rev. Cardiol. 10, 143–155 (2013).

  4. 4.

    , , , & World map of the Köppen-Geiger climate classification updated. Meteorol. Z. 15, 259 (2006).

  5. 5.

    World Health Organization. Climate change 2014: impacts, adaptation, and vulnerability. WHO (2017).

  6. 6.

    et al. Increase in out-of-hospital cardiac arrest attended by the medical mobile intensive care units, but not myocardial infarction, during the 2003 heat wave in Paris, France. Crit. Care Med. 37, 3079–3084 (2009).

  7. 7.

    & Low temperature, high barometer and sudden death. JAMA 87, 1987 (1926).

  8. 8.

    & Coronary occlusion, heart failure, and environmental temperatures. Am. Heart J. 16, 701–713 (1938).

  9. 9.

    & The relationship between sudden changes in weather and the occurrence of acute myocardial infarction. Am. Heart J. 49, 9–20 (1955).

  10. 10.

    , & The increased frequency of acute myocardial infarction during summer months in a warm climate; a study of 1,386 cases from Dallas, Texas. Am. Heart J. 45, 741–748 (1953).

  11. 11.

    & The seasonal incidence of myocardial infarction in New Orleans. Am. J. Med. Sci. 242, 468–474 (1961).

  12. 12.

    Morbid conditions at death in old men. J. Chronic Dis. 21, 761–779 (1969).

  13. 13.

    Mortality from heat illness and heat-aggravated illness in the United States. Environ. Res. 5, 1–58 (1972).

  14. 14.

    , & Survival in a coronary care unit. South. Med. J. 68, 947–951 (1975).

  15. 15.

    The Eurowinter Group. Cold exposure and winter mortality from ischaemic heart disease, cerebrovascular disease, respiratory disease, and all causes in warm and cold regions of Europe. Lancet 349, 1341–1346 (1997).

  16. 16.

    et al. Cold periods and coronary events: an analysis of populations worldwide. J. Epidemiol. Community Health 59, 551–557 (2005).

  17. 17.

    et al. Effects of air temperature on climate-sensitive mortality and morbidity outcomes in the elderly; a systematic review and meta-analysis of epidemiological evidence. EBioMedicine 6, 258–268 (2016).

  18. 18.

    , & Cardiovascular response to thermoregulatory challenges. Am. J. Physiol. Heart Circ. Physiol. 309, H1793–H1812 (2015).

  19. 19.

    et al. Mortality risk attributable to high and low ambient temperature: a multicountry observational study. Lancet 386, 369–375 (2015).

  20. 20.

    et al. Spatial patterns of heat-related cardiovascular mortality in the Czech Republic. Int. J. Environ. Res. Public Health 13, 284 (2016).

  21. 21.

    & Exchanges of heat and tolerances to cold in men exposed to outdoor weather. Am. J. Physiol. 146, 507–537 (1946).

  22. 22.

    Physiological effects of cold exposure. Int. Rev. Physiol. 15, 29–69 (1977).

  23. 23.

    Thermal, metabolic, and cardiovascular changes in men and women during cold stress. Med. Sci. Sports Exerc. 20 (Suppl.), S185–S192 (1988).

  24. 24.

    Age-dependent changes in temperature regulation — a mini review. Gerontology 58, 289–295 (2012).

  25. 25.

    et al. The effects of cold and exercise on the cardiovascular system. Heart 101, 808–820 (2015).

  26. 26.

    & Mechanisms of heat exchange: biophysics and physiology. Compr. Physiol. (2011).

  27. 27.

    & Human physiological responses to cold exposure: acute responses and acclimatization to prolonged exposure. Auton. Neurosci. 196, 63–74 (2016).

  28. 28.

    et al. Effects of low temperature on shear-induced platelet aggregation and activation. J. Trauma 57, 216–223 (2004).

  29. 29.

    et al. Air temperature and inflammatory responses in myocardial infarction survivors. Epidemiology 19, 391–400 (2008).

  30. 30.

    , , , & Associations between outdoor temperature and markers of inflammation: a cohort study. Environ. Health 9, 42 (2010).

  31. 31.

    & Impaired defense of core temperature in aged humans during mild cold stress. Am. J. Physiol. Regul. Integr. Comp. Physiol. 292, R103–R108 (2007).

  32. 32.

    , , & Response to rest and exercise in the cold: effects of age and aerobic fitness. J. Appl. Physiol. 76, 72–78 (1994).

  33. 33.

    , , & Age-related thermoregulatory differences during core cooling in humans. Am. J. Physiol. Regul. Integr. Comp. Physiol. 279, R349–R354 (2000).

  34. 34.

    & Reflex peripheral vasoconstriction is diminished in older men. J. Appl. Physiol. 80, 512–515 (1996).

  35. 35.

    & Aging and human cold tolerance. Exp. Aging Res. 23, 45–67 (1997).

  36. 36.

    Effect of cold exposure on older humans. Int. J. Sports Med. 23, 86–92 (2002).

  37. 37.

    , & Preferred room temperature of young versus aged males: the influence of thermal sensation, thermal comfort, and affect. J. Gerontol. A Biol. Sci. Med. Sci. 50, M216–M221 (1995).

  38. 38.

    , & Habituation of thermal sensations, skin temperatures, and norepinephrine in men exposed to cold air. J. Appl. Physiol. 90, 1211–1218 (2001).

  39. 39.

    et al. Exertional fatigue, sleep loss, and negative energy balance increase susceptibility to hypothermia. J. Appl. Physiol. 85, 1210–1217 (1998).

  40. 40.

    & Skin temperature of Australian aboriginals under varying atmospheric conditions. Aust. J. Exp. Biol. Med. Sci. 16, 1–18 (1938).

  41. 41.

    , , & Association between low temperature during winter season and hospitalizations for ischemic heart diseases in New York State. J. Environ. Health 78, 66–74 (2016).

  42. 42.

    et al. Characterizing the relationship between temperature and mortality in tropical and subtropical cities: a distributed lag non-linear model analysis in Hue, Viet Nam, 2009–2013. Glob. Health Action 9, 28738 (2016).

  43. 43.

    et al. Association of cold temperature and mortality and effect modification in the subtropical plateau monsoon climate of Yuxi, China. Environ. Res. 150, 431–437 (2016).

  44. 44.

    et al. High diurnal temperature range and mortality: effect modification by individual characteristics and mortality causes in a case-only analysis. Sci. Total Environ. 544, 627–634 (2016).

  45. 45.

    , , & The role of influenza in the delay between low temperature and ischemic heart disease: evidence from simulation and mortality data from Japan. Int. J. Environ. Res. Public Health 13, 454 (2016).

  46. 46.

    et al. Drier air, lower temperatures, and triggering of paroxysmal atrial fibrillation. Epidemiology 26, 374–380 (2015).

  47. 47.

    , , , & Multiple trigger points for quantifying heat-health impacts: new evidence from a hot climate. Environ. Health Perspect. 124, 176–183 (2016).

  48. 48.

    et al. Ambient temperature and risk of cardiovascular hospitalization: an updated systematic review and meta-analysis. Sci. Total Environ. 550, 1084–1102 (2016).

  49. 49.

    et al. Rapid weather changes are associated with increased ischemic stroke risk: a case-crossover study. Eur. J. Epidemiol. 31, 137–146 (2016).

  50. 50.

    , , & Emergency cardiovascular hospitalization risk attributable to cold temperatures in Hong Kong. Circ. Cardiovasc. Qual. Outcomes 9, 135–142 (2016).

  51. 51.

    et al. The short-term effect of ambient temperature on mortality in Wuhan, China: a time-series study using a distributed lag non-linear model. Int. J. Environ. Res. Public Health 13, 722 (2016).

  52. 52.

    et al. Impaired skin blood flow response to environmental heating in chronic heart failure. Eur. Heart J. 27, 338–343 (2006).

  53. 53.

    & Invited review: aging and human temperature regulation. J. Appl. Physiol. 95, 2598–2603 (2003).

  54. 54.

    & in Medical Aspects of Harsh Environments Vol. 1 Ch. 5 (eds Pandolf, K. B. & Burr, R. E.) 161–208 (2001).

  55. 55.

    & Limitations to thermoregulation and acclimatization challenge human adaptation to global warming. Int. J. Environ. Res. Public Health 12, 8034–8074 (2015).

  56. 56.

    et al. Increased platelet and red cell counts, blood viscosity, and plasma cholesterol levels during heat stress, and mortality from coronary and cerebral thrombosis. Am. J. Med. 81, 795–800 (1986).

  57. 57.

    et al. Altered thermoregulatory responses in heart failure patients exercising in the heat. Physiol. Rep. 4, e13022 (2016).

  58. 58.

    & Influence of aerobic fitness and body fatness on tolerance to uncompensable heat stress. J. Appl. Physiol. 91, 2055–2063 (2001).

  59. 59.

    & Heat acclimation, aerobic fitness, and hydration effects on tolerance during uncompensable heat stress. J. Appl. Physiol. 84, 1731–1739 (1998).

  60. 60.

    & Heat shock proteins and the heat shock response during hyperthermia and its modulation by altered physiological conditions. Prog. Brain Res. 162, 433–446 (2007).

  61. 61.

    , , , & Cold related mortalities and protection against cold in Yakutsk, eastern Siberia: observation and interview study. BMJ 317, 978–982 (1998).

  62. 62.

    Snow-shovelling and coronary deaths. BMJ 1, 577 (1977).

  63. 63.

    & Increase in deaths from ischaemic heart-disease after blizzards. Lancet 1, 485–487 (1979).

  64. 64.

    & The immediate antecedents of myocardial infarction in active men. Can. Med. Assoc. J. 109, 19–22 (1973).

  65. 65.

    et al. Seasonal variation in food intake, physical activity, and body weight in a predominantly overweight population. Eur. J. Clin. Nutr. 60, 519–528 (2006).

  66. 66.

    et al. Seasonality of cardiovascular risk factors: an analysis including over 230 000 participants in 15 countries. Heart 100, 1517–1523 (2014).

  67. 67.

    et al. Seasonal variations in mood and behavior associate with common chronic diseases and symptoms in a population-based study. Psychiatry Res. 238, 181–188 (2016).

  68. 68.

    et al. Winter is coming: nightmares and sleep problems during seasonal affective disorder. J. Sleep Res. 25, 612–619 (2016).

  69. 69.

    Seasonal affective disorder: an overview of assessment and treatment approaches. Depress. Res. Treat. 2015, 178564 (2015).

  70. 70.

    et al. Light therapy for preventing seasonal affective disorder. Cochrane Database Syst. Rev. 11, CD011269 (2015).

  71. 71.

    et al. Increased seasonal variation in serotonin transporter binding in seasonal affective disorder. Neuropsychopharmacology 41, 2447–2454 (2016).

  72. 72.

    et al. Serotonin transporter binding is reduced in seasonal affective disorder following light therapy. Acta Psychiatr. Scand. 134, 410–419 (2016).

  73. 73.

    The vitamin D deficiency pandemic and consequences for nonskeletal health: mechanisms of action. Mol. Aspects Med. 29, 361–368 (2008).

  74. 74.

    et al. Seasonal epidemiology of serum 25-hydroxyvitamin D concentrations among healthy adults living in rural and urban areas in Mongolia. Nutrients 8, 592 (2016).

  75. 75.

    & The role of vitamin D in diabetes and cardiovascular disease: an updated review of the literature. Dis. Markers 2015, 580474 (2015).

  76. 76.

    et al. Influence of ultraviolet radiation on the association between 25-hydroxy vitamin D levels and cardiovascular risk factors in obesity. J. Pediatr. 171, 83–89.e1 (2016).

  77. 77.

    et al. The association of vitamin D status with dyslipidaemia and biomarkers of endothelial cell activation in older Australians. Nutrients 8, 457 (2016).

  78. 78.

    et al. Can vitamin D deficiency cause diabetes and cardiovascular diseases? Present evidence and future perspectives. Nutr. Metab. Cardiovasc. Dis. 22, 81–87 (2012).

  79. 79.

    et al. 1,25-dihydroxyvitamin D3 regulates VEGF production through a vitamin D response element in the VEGF promoter. Atherosclerosis 204, 85–89 (2009).

  80. 80.

    , , , & Vitamin D improves endothelial function in patients with type 2 diabetes mellitus and low vitamin D levels. Diabet. Med. 25, 320–325 (2008).

  81. 81.

    , & Plasma 25-hydroxyvitamin D and regulation of the renin-angiotensin system in humans. Hypertension 55, 1283–1288 (2010).

  82. 82.

    , , & Blood 25-hydroxyvitamin D concentration and hypertension: a meta-analysis. J. Hypertens. 29, 636–645 (2011).

  83. 83.

    , , , & Ultraviolet B and blood pressure. Lancet 352, 709–710 (1998).

  84. 84.

    et al. Vitamin D deficiency is independently associated with the extent of coronary artery disease. Eur. J. Clin. Invest. 44, 634–642 (2014).

  85. 85.

    et al. Cosinor modelling of seasonal variation in 25-hydroxyvitamin D concentrations in cardiovascular patients in Norway. Eur. J. Clin. Nutr. 70, 517–522 (2016).

  86. 86.

    et al. Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the American Heart Association. Circulation 121, 2331–2378 (2010).

  87. 87.

    et al. Short term exposure to air pollution and stroke: systematic review and meta-analysis. BMJ 350, h1295 (2015).

  88. 88.

    et al. Long-term exposure to air pollution and markers of inflammation, coagulation, and endothelial activation: a repeat-measures analysis in the Multi-Ethnic Study of Atherosclerosis (MESA). Epidemiology 26, 310–320 (2015).

  89. 89.

    Inhalation of fine particulate air pollution and ozone causes acute arterial vasoconstriction in healthy adults. Circulation 105, 1534–1536 (2002).

  90. 90.

    et al. Air pollution related prothrombotic changes in persons with diabetes. Environ. Health Perspect. 118, 191–196 (2010).

  91. 91.

    et al. Effects of ambient air pollution on hemostasis and inflammation. Environ. Health Perspect. 117, 995–1001 (2009).

  92. 92.

    et al. Associations between size-fractionated particulate air pollution and blood pressure in a panel of type II diabetes mellitus patients. Environ. Int. 80, 19–25 (2015).

  93. 93.

    et al. Assessment of the possible association of air pollutants PM10, O3, NO2 with an increase in cardiovascular, respiratory, and diabetes mortality in Panama City: a 2003 to 2013 data analysis. Medicine (Baltimore) 95, e2464 (2016).

  94. 94.

    et al. Impact of meteorological parameters and air pollution on emergency department visits for cardiovascular diseases in the city of Zagreb, Croatia. Arh. Hig. Rada Toksikol. 67, 240–246 (2016).

  95. 95.

    , , & Single and combined effects of air pollutants on circulatory and respiratory system-related mortality in Belgrade, Serbia. J. Toxicol. Environ. Health A 79, 17–27 (2016).

  96. 96.

    et al. Short-term effects of fine particulate air pollution on cardiovascular hospital emergency room visits: a time-series study in Beijing, China. Int. Arch. Occup. Environ. Health 89, 641–657 (2016).

  97. 97.

    et al. Extreme weather and air pollution effects on cardiovascular and respiratory hospital admissions in Cyprus. Sci. Total Environ. 542, 247–253 (2016).

  98. 98.

    et al. Associations of short-term exposure to traffic-related air pollution with cardiovascular and respiratory hospital admissions in London, UK. Occup. Environ. Med. 73, 300–307 (2016).

  99. 99.

    et al. Particulate matter and hospital admissions for stroke in Beijing, China: modification effects by ambient temperature. J. Am. Heart Assoc. 5, e003437 (2016).

  100. 100.

    et al. Mortality burden of ambient fine particulate air pollution in six Chinese cities: results from the Pearl River Delta study. Environ. Int. 96, 91–97 (2016).

  101. 101.

    et al. Ischemic heart disease mortality and long-term exposure to source-related components of U.S. fine particle air pollution. Environ. Health Perspect. 124, 785–794 (2016).

  102. 102.

    et al. The effects of air pollution and weather conditions on the incidence of acute myocardial infarction. Am. J. Emerg. Med. 34, 449–454 (2016).

  103. 103.

    , , , & The influence of nitrogen dioxide on arrhythmias in Spain and its relationship with atmospheric circulation. Cardiovasc. Toxicol. 17, 88–96 (2017).

  104. 104.

    , , , & Regionalized life cycle impact assessment of air pollution on the global scale: damage to human health and vegetation. Atmos. Environ. 134, 129–137 (2016).

  105. 105.

    , , & Climate and environmental triggers of acute myocardial infarction. Eur. Heart J. 38, 955–960 (2017).

  106. 106.

    et al. Global association of air pollution and heart failure: a systematic review and meta-analysis. Lancet 382, 1039–1048 (2013).

  107. 107.

    & Influenza vaccination promotes stable atherosclerotic plaques in apoE knockout mice. Atherosclerosis 217, 97–105 (2011).

  108. 108.

    , & Role of acute infection in triggering acute coronary syndromes. Lancet Infect. Dis. 10, 83–92 (2010).

  109. 109.

    , & Influenza as a trigger for acute myocardial infarction or death from cardiovascular disease: a systematic review. Lancet Infect. Dis. 9, 601–610 (2009).

  110. 110.

    et al. Seasonal influenza infections and cardiovascular disease mortality. JAMA Cardiol. 1, 274–281 (2016).

  111. 111.

    , , & Triggers of ischemic stroke: a systematic review. Stroke 41, 2669–2677 (2010).

  112. 112.

    , , & Short-term effects of air temperature on cause-specific cardiovascular mortality in Bavaria, Germany. Heart 100, 1272–1280 (2014).

  113. 113.

    & The relationship between mortality caused by cardiovascular diseases and two climatic factors in densely populated areas in Norway and Ireland. J. Cardiovasc. Risk 7, 369–375 (2000).

  114. 114.

    , , & Exploring the periodicity of cardiovascular events in Switzerland: variation in deaths and hospitalizations across seasons, day of the week and hour of the day. Int. J. Cardiol. 168, 2195–2200 (2013).

  115. 115.

    , & Ischemic heart disease hospitalization among older people in a subtropical city — Hong Kong: does winter have a greater impact than summer? Int. J. Environ. Res. Public Health 11, 3845–3858 (2014).

  116. 116.

    et al. The seasonality of acute coronary syndrome and its relations with climatic parameters. Am. J. Emerg. Med. 29, 768–774 (2011).

  117. 117.

    , , & Seasonal distribution of acute myocardial infarction in the second National Registry of Myocardial Infarction. J. Am. Coll. Cardiol. 31, 1226–1233 (1998).

  118. 118.

    & Cold-related cardiac mortality in King County, Washington, USA 1980–2001. Ann. Hum. Biol. 32, 525–537 (2005).

  119. 119.

    , , , & Seasonality and daily weather conditions in relation to myocardial infarction and sudden cardiac death in Olmsted County, Minnesota, 1979 to 2002. J. Am. Coll. Cardiol. 48, 287–292 (2006).

  120. 120.

    et al. Characteristics of cardiovascular deaths in forensic medical cases in Budapest, Vilnius and Tallinn. J. Forensic Leg. Med. 20, 968–971 (2013).

  121. 121.

    , , , & Seasonal variation in chronic heart failure hospitalizations and mortality in France. Circulation 100, 280–286 (1999).

  122. 122.

    , , & Heart failure in a cold climate: seasonal variation in heart failure-related morbidity and mortality. J. Am. Coll. Cardiol. 39, 760–766 (2002).

  123. 123.

    et al. Analysis of 27,248 hospital discharges for heart failure: a study of an administrative database 1998–2002. Rev. Clin. Esp. 208, 281–287 (2008).

  124. 124.

    et al. Is greater temperature change within a day associated with increased emergency hospital admissions for heart failure? Circ. Heart Fail. 6, 930–935 (2013).

  125. 125.

    et al. Seasonal variation in hospital discharge diagnosis of atrial fibrillation: a population-based study. Epidemiology 13, 211–215 (2002).

  126. 126.

    , , , & Seasonal variation in morbidity and mortality related to atrial fibrillation. Int. J. Cardiol. 97, 283–288 (2004).

  127. 127.

    , , & Is there a clinically significant seasonal component to hospital admissions for atrial fibrillation? BMC Health Serv. Res. 4, 5 (2004).

  128. 128.

    et al. Seasonal variation in the occurrence of stroke in a Finnish adult population: the FINMONICA Stroke Register. Finnish monitoring trends and determinants in cardiovascular disease. Stroke 27, 1774–1779 (1996).

  129. 129.

    , , , & Average temperature, diurnal temperature variation, and stroke hospitalizations. J. Stroke Cerebrovasc. Dis. 25, 1489–1494 (2016).

  130. 130.

    , , , & Association between hemorrhagic stroke occurrence and meteorological factors and pollutants. BMC Neurol. 16, 59 (2016).

  131. 131.

    et al. Seasonal variations in cardiovascular-related mortality but not hospitalization are modulated by temperature and not climate type: a systematic review and meta-analysis of 4.5 million events in 26 countries. Circulation 134, A16759–A16759 (2016).

  132. 132.

    , , , & Seasonal patterns of cardiovascular disease mortality of adults in Burkina Faso, West Africa. Trop. Med. Int. Health 15, 1082–1089 (2010).

  133. 133.

    et al. Diurnal, weekly and seasonal variation of sudden cardiac death in northern Tunisia [French]. Presse Med. 43, e39–e45 (2014).

  134. 134.

    , , & Seasonal variation in sudden death in the Negev desert region of Israel. Isr. Med. Assoc. J. 2, 17–21 (2000).

  135. 135.

    et al. Circadian rhythm in sudden cardiac death: a retrospective study of 2,665 cases. Angiology 57, 197–204 (2006).

  136. 136.

    et al. Acute effects of particulate air pollution on the incidence of coronary heart disease in Shanghai, China. PLoS ONE 11, e0151119 (2016).

  137. 137.

    et al. Diurnal, weekly and seasonal variation of sudden death: population-based analysis of 24,061 consecutive cases. Eur. Heart J. 21, 315–320 (2000).

  138. 138.

    , , , & Temporal trends in cardiovascular demand in EMS: weekday versus weekend differences. Chronobiol. Int. 32, 731–738 (2015).

  139. 139.

    et al. Climate impacts on myocardial infarction deaths in the Athens territory: the CLIMATE study. Heart 92, 1747–1751 (2006).

  140. 140.

    , , & Hospitalization and mortality rates for heart failure in public hospitals in Sao Paulo. Arq. Bras. Cardiol. 97, 402–407 (2011).

  141. 141.

    & Seasonal variation in case fatality rate in Korean patients with acute myocardial infarction using the 1997–2006 Korean National Health Insurance claims database. Acta Cardiol. 69, 513–521 (2014).

  142. 142.

    et al. Seasonal variation in incidence of acute myocardial infarction in a sub-Arctic population: the Tromso Study 1974–2004. Eur. J. Cardiovasc. Prev. Rehabil. 18, 320–325 (2011).

  143. 143.

    , , , & The short-term influence of weather on daily mortality in congestive heart failure. Arch. Environ. Occup. Health 62, 169–176 (2007).

  144. 144.

    et al. Influence of weather on daily hospital admissions for acute myocardial infarction (from the Korea Acute Myocardial Infarction Registry). Int. J. Cardiol. 144, 16–21 (2010).

  145. 145.

    et al. Seasonal and weekly patterns of hospital admissions for nonfatal and fatal myocardial infarction. Am. J. Emerg. Med. 27, 1097–1103 (2009).

  146. 146.

    & Trends in sudden cardiac death in the northern Sweden MONICA area 1985–1999. J. Intern. Med. 253, 320–328 (2003).

  147. 147.

    et al. Seasonal pattern in admissions and mortality from acute myocardial infarction in elderly patients in Isfahan, Iran. ARYA Atheroscler. 10, 46–55 (2014).

  148. 148.

    , , , & Temporal variation in case fatality of acute myocardial infarction in Finland. Ann. Med. 41, 73–80 (2009).

  149. 149.

    & Increase in mortality due to myocardial infarction in the Brazilian city of Sao Paulo during winter. Arq. Bras. Cardiol. 78, 106–109 (2002).

  150. 150.

    , , , & Association between ambient temperature and acute myocardial infarction hospitalisations in Gothenburg, Sweden: 1985–2010. PLoS ONE 8, e62059 (2013).

  151. 151.

    , , & Time of sunrise and hours with daylight may have an effect on the seasonality and diurnal variation of heart attack. Chin. Med. J. (Engl.) 122, 2107–2110 (2009).

  152. 152.

    , , & Seasonal variations in the occurrence of acute myocardial infarction in Hungary between 2000 and 2004. Int. J. Cardiol. 129, 251–254 (2008).

  153. 153.

    , & Demographic, seasonal, and spatial differences in acute myocardial infarction admissions to hospital in Melbourne Australia. Int. J. Health Geogr. 7, 42 (2008).

  154. 154.

    et al. The Lancet Countdown: tracking progress on health and climate change. Lancet 389, 1151–1164 (2017).

  155. 155.

    et al. Influence of room heating on ambulatory blood pressure in winter: a randomised controlled study. J. Epidemiol. Community Health 67, 484–490 (2013).

  156. 156.

    et al. Daytime variation in ambient temperature affects skin temperatures and blood pressure: ambulatory winter/summer comparison in healthy young women. Physiol. Behav. 149, 203–211 (2015).

  157. 157.

    & Seasonal affective disorder. Am. Fam. Physician 86, 1037–1041 (2012).

  158. 158.

    et al. Acute myocardial infarction and influenza: a meta-analysis of case-control studies. Heart 101, 1738–1747 (2015).

  159. 159.

    , , & Influenza vaccine as a coronary intervention for prevention of myocardial infarction. Heart 102, 1953–1956 (2016).

  160. 160.

    et al. Influenza vaccination in patients with chronic heart failure: the PARADIGM-HF trial. JACC Heart Fail. 4, 152–158 (2016).

  161. 161.

    et al. Effect of the adult pneumococcal polysaccharide vaccine on cardiovascular disease: a systematic review and meta-analysis. Open Heart 2, e000247 (2015).

  162. 162.

    , & Influenza vaccination, pneumococcal vaccination and risk of acute myocardial infarction: matched case-control study. CMAJ 182, 1617–1623 (2010).

  163. 163.

    Air quality warnings and outdoor activities: evidence from Southern California using a regression discontinuity design. J. Epidemiol. Community Health 64, 921–926 (2010).

  164. 164.

    et al. Evaluation of the cold weather plan for England: modelling of cost-effectiveness. Public Health 137, 13–19 (2016).

  165. 165.

    , , , & The use of community assessment for public health emergency response to evaluate nws warnings. Bull. Am. Meteorol. Soc. 95, 18–21 (2014).

  166. 166.

    , , , & Evaluation of the national weather service extreme cold warning experiment in North Dakota. Weather Clim. Soc. 6, 22–31 (2014).

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Acknowledgements

S.S. is supported by a National Health and Medical Research Council of Australia Fellowship (1041766). A.K.K. is supported by the National Health and Medical Research Council of Australia Centre of Research Excellence to Reduce Inequality in Heart Disease (044897).

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Affiliations

  1. Mary MacKillop Institute for Health Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, Victoria 3000, Australia.

    • Simon Stewart
    • , Ashley K. Keates
    • , Adele Redfern
    •  & John J. V. McMurray
  2. Institute of Cardiovascular and Medical Sciences, BHF Cardiovascular Research Centre, University of Glasgow, Glasgow G12 8TA, Scotland, UK.

    • John J. V. McMurray

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Contributions

All the authors contributed to researching data, discussions of content, writing the article, and to reviewing and editing the manuscript before submission.

Competing interests

The authors declare no competing financial interests.

Corresponding author

Correspondence to Simon Stewart.

About this article

Publication history

Published

DOI

https://doi.org/10.1038/nrcardio.2017.76

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